Lameness of the Horse | Page 5

would comprehend the technic of reduction and subsequent treatment in such cases.
Fractures are classified by many authorities as being simple, compound, and comminuted. This method is practical because it separates dissimilar conditions. There are also grouped fractures, the pathologic anatomy of which is similar. Classification on an etiological basis would attempt to associate conditions, the morbid anatomy and gravity of which would justly preclude their being combined.
Simple Fracture is a condition where the continuity of the bone has been broken without serious destruction of the soft structures adjacent, and where no opening has been made to the surface of the flesh. Such fractures do not reduce the bone to fragments. Long bones are frequently subjected to simple fracture, while short thick bones, such as the second phalanx, may suffer multiple or comminuted fractures.
Compound Fracture designates a break of bone with the destruction of the soft tissues covering it, making an open wound to the surface of the skin. This form of fracture is serious because of the attendant danger of infection, and in treatment, necessitates special precaution being taken in the application of splints that the wound may be cared for without infection of the tissues. These fractures generally occur as a result of some forceful impact through the flesh to the bone, or where the bones are driven outward by the blow. Common examples are in fractures of the metacarpus and metatarsus of the first phalanx. This kind of injury in mature horses usually produces an irreparable condition, and viewed economically, is generally considered fatal.
Comminuted Fractures, as the term implies, are those cases wherein the bone is reduced to a number of small pieces. This kind of break may be classified as simple-comminuted fracture when the skin is unbroken, and when the bone is exposed as a result of the injury, it is known as a compound-comminuted fracture. Such fractures are caused by violent contusion or where the member is caught between two objects and crushed.
Multiple Fractures.
Fractures are called multiple when the bone is reduced to a number of pieces of large size. This condition differs from a comminuted fracture in that the multiple fracture may break the bone into several pieces without the pieces being ground or crushed, and the affected bone may still retain its normal shape.
Further classification is of value in describing fractures of bone with respect to the manner in which the bone is broken--the direction of the fissure or fissures in relation to its long axis.
A fracture is transverse when the bone is broken at a right angle from its long axis. Such breaks when simple, are the least trouble to care for because there is little likelihood that the broken ends of bone will become so displaced that they will not remain in apposition. Simple transverse fracture of the metacarpus, for instance, constitutes a favorable case for treatment if other conditions are favorable.
Oblique fractures, as may be surmised, are solutions of continuity of bone in such manner that the fissure crosses the long axis of a bone at an acute or obtuse angle. These fractures are prone to injure the soft structures adjacent, and are frequently compound, as well. Moreover, because of the fact that the apposing pieces of bone are beveled, the broken ends of bone are likely to pass one another in such a way as to shorten the distance between the extremities of the injured member. Contraction of muscles also tends to exert traction upon a bone so fractured, resulting in a lateral approximation of the diaphysis and thus preventing union because the broken surfaces are not in proper contact.
Fractures are longitudinal when the fissure is parallel with the long axis of the bone. This variety of break is not infrequent in the first phalanx; and a vertical fracture of the second phalanx is also said to be longitudinal, however, there is little difference (if any, in some subjects) between the vertical and transverse diameters of this particular bone.
Green stick fractures are essentially those resulting from falls to young animals. They are usually sub-periosteal and when the periosteum is left intact or nearly so, no crepitation is discernible. If this fracture is simple, prompt recovery may be expected. Bones of young animals, because they do not contain proportionately as much mineral substance as do bones of adults, are more resilient and less apt to become completely fractured. They are, however, subject to what is known as green stick fracture.
Impacted fractures are usually occasioned by falls. When the weight of the body is suddenly caught by a member in such manner as to forcefully drive the epiphyseal portions of bone into and against the diaphysis, multiple longitudinal fractures occur at the point of least resistance. Parts so affected undergo a fibrillary separation, increasing the transverse diameter of the bone; or if